血清钙离子对小儿脓毒症及相关性弥散性血管内凝血的评估价值

The clinical value of serum calcium ion in the assessment of sepsis and septic disseminated intravascular coagulation in children

目的探讨血清钙离子对小儿脓毒症及所致弥散性血管内凝血(DIC)评估的临床价值。方法选择2013年2月—2020年3月入住本院PICU的43例脓毒症非DIC(脓毒症非DIC组)及36例脓毒症并DIC(脓毒症并DIC组)患儿为实验组,另选择46例感染非脓毒症(感染非全身炎症反应综合征SIRS组)及47例非感染(非感染组)患儿为对照组。分析比较各组血清钙离子水平,对实验组钙离子与活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、血小板计数(PLT)、C反应蛋白(CRP)、白细胞计数(WBC)等行相关性分析。结果除感染非SIRS组及非感染组外,余各组间血清钙离子有显著差异(P<0.01);脓毒症并DIC组及脓毒症非DIC组Ca、PT、APTT、FIB、PLT有显著差异(P<0.01);脓毒症并DIC组Ca与FIB呈正相关,脓毒症非DIC组Ca与PT呈负相关。结论血清钙离子对小儿脓毒症及脓毒性DIC的评估有重要临床价值,与PT、FIB存在相关性。

Objective To investigate the clinical value of serum calcium ion in the evaluation of sepsisin children and sepsis induced disseminated intravascular coagulation(DIC).Methods Selected 43 cases of children with sepsis but without DIC(sepsis non-DIC group)and 36 cases of children with sepsis complicated with DIC(sepsis and DIC group)those admitted to PICU of our hospital from February 2013 to March 2020 as the experimental groups,36 cases of children with infectious diseasebut not sepsis(infection but not withsystemic inflammatory response syndrome,SIRS)and 47 cases of children without infectious disease(non-infectious group).The serum calcium ion level in all groups was analyzed.Furthermore,the correlation between calcium ionin the test group and activated partial prothrombin time(APTT),prothrombin time(PT),fibrinogen(FIB),platelet count(PLT),C-reactive protein(CRP)and white blood cell count(WBC)were analyzed.Results Except for the non-infectious group and the infection non-SIRS group,there were significant differences in serum calcium between the other groups(P<0.01).There were significant differences in Ca,PT,APTT,FIB and PLT between the sepsis and DIC group and the sepsis non-DIC group(P<0.01).There was a positive correlation between Ca and FIB in the sepsis and DIC group,and a negative correlation between Ca and PT in the sepsis non-DIC group.Conclusions Serum calcium ion has important clinical value in the evaluation of pediatric sepsis and septic DIC,and is correlated with PT and FIB.